超声造影在原发性肝癌导管栓塞治疗效果评价中的应用研究  

Contrast-Enhanced Ultrasound in Transcatheter Arterial Chemoembolization Treatments of Hepatocellular Carcinoma

作　　者：杨洁[1] 张学兰[1] 

机构地区：[1]甘肃省人民医院超声科,兰州市730000

出　　处：《中国超声医学杂志》2012年第4期348-351,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的通过超声造影对肝动脉化疗栓塞(TACE)术治疗的原发性肝癌的观察,了解超声造影对TACE疗效的评价作用,并进一步协同TACE的治疗。方法 54例原发性肝癌患者治疗前及治疗后1周进行超声造影检查,观察肿瘤组织血供情况,了解肿瘤组织内部有无残留血供和遗漏病灶,并对未完全灭活的病灶针对性地进行TACE补充治疗。结果超声造影提示:单次TACE治疗病例中,肿瘤灭活病例和肿瘤遗漏病例均明显高于多次TACE治疗的病例(P<0.01);在单发病灶的治疗病例中,肿瘤灭活率明显高于多发病灶者,且无肿瘤遗漏(P<0.01),肿瘤的残留率单发病灶与多发病灶间无明显差异(P>0.05);TACE治疗后1个月的疗效比较统计显示,单发病灶与多发病灶的两组间完全缓解率比较,单发病灶的完全缓解率要明显高于多发病灶(P<0.01);3年生存率随访,6个月,1、2、3年生存率分别为87.5%、69.8%、45.6%、22.3%。结论 CEUS能够比较精确地反映TACE治疗后肿瘤血供阻断情况,客观地评价和反映了TACE治疗的疗效,同时为进一步寻求新的原发性肝癌治疗手段和进行必要的补充治疗提供依据。Objective To determine the value of contrast enhanced ultrasonography （CEUS） for evaluating the curative effect of transcatheter arterial chemoembolization （TACE）. Methods CEUS was used to evaluate the blood perfusion features of 54 cases HCC. Patients were examined by contrast-enhanced ultrasound before and after therapy in one week. The lesion of incomplete deactivation were supplementally treated by TACE. Results The patients with deactivation and missed lesion was significantly higher in the single_TACE group than those in the muhiple_TACE group, respectively （P〈0.01）. The deactivation of single lesion of HCC was significantly higher than those of multi ple lesions （P〈0.01）. Six months, 1 year, 2 years and 3 years of existence rate were 87.5%,69.8%,45.6%, 22.3 %, respectively. Conclusions TACE supplementary treatment evaluated and instructed by immediate contrast-enhanced ultrasound for HCC can help to destroy the lesion completely.

关 键 词：超声造影 经导管动脉化学栓塞术 原发性肝癌 

分 类 号：R735.7[医药卫生—肿瘤] R445.1[医药卫生—临床医学]